■视神经撕脱是视神经纤维在筛板水平上从球形脱离的创伤性。这是钝性眼外伤的罕见且严重的并发症。
我们报告了一名15岁男性在被马踢后被送往急诊科的病例。左眼(LE)的初始眼科检查,表现为眼睑血肿,结膜下出血,VA仅限于光感,并且存在左侧相对传入瞳孔缺损。LE的眼底扩张检查显示,广泛的玻璃体和视网膜前出血覆盖了视盘和视网膜水肿。诊断为LE视神经乳头撕脱(ONA)。事故发生五年后,LE的VA检测手部运动,眼底检查显示视盘有明显的拖曳,纤维胶质瘢痕,视网膜血管狭窄和视网膜上皮增生。
■在ONA的情况下,由于玻璃体和视网膜出血覆盖视神经,最初可以错过撕脱,在这种情况下,多模态成像可以是诊断和评估相关眼损伤的有用工具。撕脱的视神经的愈合过程的特征在于纤维胶质细胞增殖的发展。视觉结果较差,最终视敏度范围从光感知或总ONA中没有光感知。
■视头部神经撕脱是一种罕见且严重的疾病,由于相关的介质混浊,初步诊断具有挑战性。预后较差,损伤导致永久性视力障碍。
UNASSIGNED: Optic nerve avulsion is a traumatic disinsertion of optic nerve fibres from the globe at the level of the lamina cribrosa. It is an uncommon and severe complication of blunt ocular trauma.
UNASSIGNED: We report the
case of a 15 years old male presented to the emergency department after being kicked by a horse. Initial ophthalmologic examination of the left eye (LE), exhibited eyelid hematoma, subconjunctival hemorrhage, VA was limited to light perception and there was a left relative afferent pupillary defect. Dilated fundus examination of the LE revealed an extensive vitreous and preretinal hemorrhage overlaying the optic disc and retina edema.The diagnosis of LE optic nerve head avulsion (ONA) was made. Five years after the accident, VA of LE detecting hand motion, fundus examination revealed a superior dragging of the optic disc, fibroglial scarring, retinal vessel narrowing and retinal epithelium hyperplasia.
UNASSIGNED: In
case of ONA, the avulsion can be missed initially due to vitreous and retinal hemorrhage overlaying the optic nerve, in such cases multimodal imaging can be a useful tool to the diagnosis and to evaluate associated ocular damage. Healing process of the avulsed optic nerve is characterized by the development of fibroglial proliferation. Visual outcome is poor and the final visual acuity range from light perception or no light perception in total ONA.
UNASSIGNED: Optic head nerve avulsion is a rare and severe disease and initial diagnosis is challenging due to associated media opacities. The prognosis is poor and the injury leads to permanent visual impairment.